Project Summary/Abstract: The most common cause of death among hospitalized patients in noncoronary intensive care units is sepsis. Despite interventions, sepsis affects more than 800,000 Americans each year, incurs a mortality rate of 30% to 80%, and causes more than 250,000 deaths per year, at a cost of $16.7 billion. More Americans die in 1 year from severe sepsis than from breast cancer, lung cancer, and stroke combined. An investigation of the differences in morbidity and mortality between early and late onset of septic shock in ICU patients found that septic shock is more severe when of early onset, as reflected by more severe organ dysfunction, greater lactic acidosis, and higher vasopressor requirements, yet the outcome is better, as reflected by a shorter duration of the shock episode, shorter ICU stay, and slightly lower mortality rates. Early detection of sepsis would be more effective when the diagnostic modalities are combined with hemodynamic monitoring, central venous O2 saturation monitoring, and sublingual capnography. Most hemodynamic studies in sepsis and septic shock evaluate therapeutic strategies to increase cardiac output, blood pressure, and organ blood flow. Even though the skin and other microcirculatory areas have enjoyed rigorous research activities, so far, no monitoring techniques have yet been validated in terms of reproducibility. Recent studies showed altered sublingual microcirculatory blood flow in septic patients and a possible correlation between the severity of microcirculatory alterations and survival. The main objective of this research is to investigate the utility of a new imaging technique for realtime, noninvasive, and quantitative measurements of sublingual and/or mucosal blood velocity in humans for the purpose of providing information on sepsis. The innovation of this project lies in the application of the new technique to measure, quantitatively, sublingual blood velocity for monitoring sepsis. The ultimate product of this research will be a small, handheld device that provides real-time, noninvasive, and quantitative measurements of sublingual blood velocity for the purpose of monitoring sepsis in ICUs. This device would provide vital information to the clinician on the state of the patient's microcirculation to allow the application of more timely interventions. Project Narrative: The most common cause of death among hospitalized patients in noncoronary intensive care units is sepsis. The onset of sepsis changes the blood velocities of the tongue. This research is to investigate the utility of a new imaging technique for real-time measurements of blood velocity of the patient's tongue in the intensive care units. [unreadable] [unreadable] [unreadable]